Thunder Bay

Catholic hospitals should provide medical assistance in dying, Dying with Dignity says

Palliative care patients at St. Joseph's Care Group in Thunder Bay, Ont., must transfer to the regional hospital to access medical assistance in dying.

10 people in Thunder Bay district received medical assistance in dying between June and January

Patients at some healthcare facilities in the Thunder Bay district need to transfer to the regional hospital and the end of their lives to access medical assistance in dying. (Chris Kreussling)
Palliative care patients at St. Joseph's Care Group in Thunder Bay, Ont., must transfer to the regional hospital to access medical assistance in dying.

It's part of a protocol established among health care providers in the region to provide the service while respecting the Catholic institution's faith-based objection to it.

But it's not a satisfactory solution, especially considering St. Joseph's role as one of the main providers of palliative care in the region, according to Shanaaz Gokool, the Chief Executive Officer of the advocacy Dying with Dignity.

"We're talking about people who are very frail and very vulnerable and if there are any delays in that transfer because the transferring institution doesn't have an available bed, that could be a delay and that could be a denial for the person to receive assisted death if they lose capacity [to consent to it]" Gokool said.

"Then there's the psychological trauma on the part of that person and their family who may feel abandoned saying 'I was good enough to stay here when I wanted pain management, but now that I want access to my charter right, my human right to an assisted death, and I'm eligible — you tell me I've got to go," she said.

Ten people accessed assisted dying within the Thunder Bay region between June, when the legislation came into force and January, according to a report from the coroner's office.

Some of those people were transferred from St. Joseph's to Thunder Bay Regional Health Sciences Centre, said Cathy Covino, the director of quality and risk management at the health sciences centre.

Communication between the two facilities starts early in the process and the transfers that have happened have gone smoothly, she said.

"We work with the family around that and the physician and arrange for that transfer to occur the day before so you're used to the nurse, you're used to the unit," Covino said.

Conscientious objectors

A small number of doctors at the regional hospital have expressed a willingness to provide medical assistance in dying, and the hospital respects the rights of both doctors and nurses to conscientiously object, she said.

Dying with Dignity filed access to information requests to Local Health Integration Networks (LHINs) in several Ontario cities and found that Thunder Bay's LHIN was among the leaders early on, when it came to developing protocols for medical assistance in dying.

Still, Gokool said, Catholic institutions have a key role to play in providing end of life care and should not be allowed to opt out.

Health care providers within Catholic institutions may suffer for not being able to see a long-term patient's care through to the end, she said and their rights as individuals who may want to provide care should not be overridden by their employer.

"People should absolutely be able to have their right of conscience," she said. "Conscience rights aren't just for people who object to something, they're also positive rights and providers and staff in those objecting facilities — their right of conscience right is being denied on the part of the facility."